Essentials and Future Directions of Robotic Colon Surgery

Abstract

Since the introduction of laparoscopic cholecystectomy, the surgical approach for many intra-abdominal diseases has dramatically changed. Laparoscopic colectomy is now widely performed for both benign and malignant conditions. However, lack of three-dimensional visualization, limited maneuverability with rigid instruments, poor ergonomics, impact of physiological tremor, assistant-dependent camera movements, and retraction are the major drawbacks of laparoscopy. Robotic surgery was developed in order to overcome these technical difficulties of conventional laparoscopy. Thus, the introduction of the da Vinci robotic surgical system has fundamentally changed the minimally invasive approach in the field of colon and rectal surgery. The initial experiences with robotic colectomy were reported in the early 2000s. Robotic colon and rectal surgery can be technically demanding, but, if performed by experienced surgeons, operative trauma remains minimal while dexterity is enhanced and visualization improved. In this chapter, I will describe the technical aspects of robotic colon surgery and review the outcomes in the literature, as well as highlight future directions of colon surgery.